community health council meeting minutes - monday, january

Community Health Council Public Meeting Agenda

Monday, January 13, 2020 6:00 - 8:00 pm Gladys McCoy Building, 850

Integrated Clinical Services Mission: “Providing services that improve health and wellness for individuals, families, and our communities.”

Our Meeting Process Focuses on the Governance of Community Health Centers

-Use Meeting Agreements (in English and Spanish) located on name tents -Meetings are open to the public -Guests are welcome to observe

-Use timekeeper to focus on agenda -Use note cards for questions/comments outside of agenda items and for guest

questions

Council Members “D”eb Abney; Dave Aguayo (Treasurer); Fabiola Arreola (Vice-Chair); Jon Cole

(Member-at-Large); Tamia Deary(Member-at-Large); Iris Hodge; Susana Mendoza; Harold Odhiambo (Chair); Pedro Sandoval Prieto (Secretary); Wendy Shumway

Item Process/Who Time Desired Outcome

Call to Order/Welcome

● Chair, Harold Odhiambo

● Introductions and Icebreaker

6:00-6:10 (10 min)

Call to order Review processes Everyone introduce themselves

Minutes

VOTE REQUIRED

● Review and approve the December Minutes

6:10-6:15 (5 min)

Council votes to approve and Secretary signs

Branding Update Logos

● Steve Kokes and Christina Bertalot from Coates Kokes

6:15-6:45 (30 min)

Discussion and Council feedback

Monthly Budget Report ● Senior Manager Business Ops, Mark Lewis

6:45-6:55 (10 min)

Council receives report

New Policy: HC Credit-Balance Policy

and Policy Update for

FIS.01.06

● Senior Manager Business Ops, Mark Lewis

6:55-7:05 (10 min)

Council discussion and vote

VOTES REQUIRED

Break 7:05-7:15 (10 min)

Take a break and mingle

New Member Ballot Vote

Kerry Hoeschen

● CHC Coordinator, Linda Niksich and CHC Secretary, Pedro Sandoval Prieto

7:15-7:20 (5 min)

Council members vote via ballot and Secretary verifies

Succession Plan Implementation

VOTES REQUIRED

● Interim ICS Director

7:20-7:30 (10 min)

Discussion and vote to approve Interim Director

ICS Strategic Updates ● ICS Deputy Director, Adrienne Daniels

7:30-7:40 (10 min)

Council receives Health Center Updates through the Strategic Plan lenz

Council Business Committee Updates

VOTES REQUIRED

● Executive Committee Update; Chair, Harold Odhiambo

● Nominating Committee Update

● 2020 Meeting Dates Calendar

● Certificates of Appreciation

● 2020 Member Binders

7:40-8:00 (20 min)

Council receives updates from Chair and Nominating Committee Board members receive 2019 Certificates of Appreciation and new binders for 2020

Adjourn Meeting ● Chair, Harold Odhiambo

8:00 Goodnight!

1

MCCHC Rebranding

2

Assignment recap

Create a new brand identity for MCCHC that: Unifies the Community Health Center Retains a connection to Multnomah County Creates separation from any negative County baggageReinforced credibility

3

Deliverables

Name TaglineLogo Templates and design standards for brand rollout

4

Process

Phases Phase 1 – Discovery and ResearchPhase 2 – Strategic Direction and Messaging Phase 3 – Brand identity development + rollout

5

Process


6

Process


Audiences engaged Patient focus groups One-on-one staff interviewsSurvey at ICS all-staff meetingCHC Board County and Health Department leadership

7

Phase 1 – Discovery and Research

The good Maintaining a warm and welcoming environmentCultural competencies are a strength to celebrateIntegration with the communityRecognition/appreciation for the patient’s voice Trauma-informed and patient-centered care

The bad Misperception of “care of last resort” Fear of government

The ugly Doctor couldn’t get a job elsewhere Fear of being denied access

8

Phase 2 – Strategic Direction and Messaging

Your place to be healthy, be heard and belong.

9

Phase 3 – Brand identity development

Name 9 name finalists were explored

Welcome Health emerged as the agency recommendation and the stakeholder preference

Short and clearly articulates a strong value of the County and Health Dept.An excellent option for health literacy concerns – per guidance from sub-contractor VerbioTouches on three sub-values for the FQHC:

A place to be greetedA place to be celebrated and connected with other peopleA safe place to find refuge

10

Phase 3 – Brand identity development

Tagline Multnomah County was recommended from a list of longer alternativesSimplest and strongest way to make the County connection

Alternative linesMultnomah County Health DepartmentMultnomah County HealthcareMultnomah County logo (co-branded visual approach)

11

Logo

13

Logo with font alternatives 1 2

3 4

14

Color options

1 2 3 4

15

Final Discussion

16

Next Steps

1. Address CHC feedback, if necessary

2. Present logo and tagline to County leadership for final approval

3. Share final logo with CHC

4. Move into Phase 4 – Rollout

Multnomah County - Federally Qualified Health Center

Prepared by: Larry Mingo

Oct 2019

Monthly Dashboard

Notes: Primary Care and Dental visit counts are based on an average of days worked. School Based Health Clinic visit counts are based on average days clinics are open and school is in session.

* SBHC clinics are closed during the month July except Parkrose SBHC

FQHC Weekly Billable Visits Per Department

2 of 7

578 577 549515

553 565 544 525 529489 474 491 498 523 511 505

546505 482 507

447 467 489436 455 476

100

200

300

400

500

600

700

800

900

1,000

Sep-

17O

ct-1

7N

ov-1

7D

ec-1

7Ja

n-18

Feb-

18M

ar-1

8Ap

r-18

May

-18

Jun-

18Ju

l-18

Aug-

18Se

p-18

Oct

-18

Nov

-18

Dec

-18

Jan-

19Fe

b-19

Mar

-19

Apr-1

9M

ay-1

9Ju

n-19

Jul-1

9Au

g-19

Sep-

19O

ct-1

9Avg

Billa

ble

Visi

ts/W

orkd

ay

Primary Care Average Billable Visits Per Workday

Avg Billable Visits/WorkdayFY20 Target is 717 visits per day

276

319335

294

325312

333321 316

275

309 312 303329 322 312 308

274

100

200

300

400

Jan-

17Fe

b-17

Mar

-17

Apr-1

7M

ay-1

7Ju

n-17

Jul-1

7Au

g-17

Sep-

17O

ct-1

7N

ov-1

7D

ec-1

7Ja

n-18

Feb-

18M

ar-1

8Ap

r-18

May

-18

Jun-

18Ju

l-18

Aug-

18Se

p-18

Oct

-18

Nov

-18

Dec

-18

Jan-

19Fe

b-19

Mar

-19

Apr-1

9M

ay-1

9Ju

n-19

Jul-1

9Au

g-19

Sep-

19O

ct-1

9

Avg

Billa

ble

Visi

ts/W

orkd

ay

Dental Average Billable Visits Per Workday

Avg Billable Visits/Workday FY20 Target :362 visits per dayPrevious Year Billable Visits

72 69 74 74 79

10293

63 70

29

1128

7770 72

93

6480

73 70 68

30

1024

6864

0

20

40

60

80

100

120

Sept

17

Oct

17

Nov

17

Dec

17

Jan

18Fe

b 18

Mar

18

April

19

May

18

Jun

18 J

uly

18 A

ug 1

8Se

p 18

Oct

18

Nov

18

Dec

18

Jan

19Fe

b 19

Mar

19

Apr 1

9M

ay 1

9Ju

n 19

Jul 1

9Au

g 19

Sep

19O

ct 1

9

Avg

Billa

ble

Visi

ts/W

orkd

ay

Student Health Center Average Billable Visits Per Workday

Avg Billable Visits /WorkdayPrevious Year Billable VisitsTarget FY20 is 71 visits per day Sep - Jun, & 9 Jul - Aug

Comments:Primary Care target % of Uninsured Visits for FY18: 16%; for FY19: 13.25%; for FY20 13.27%Dental target % of Uninsured Visits for FY18: 12%; for FY19: 14.85%; for FY20 11.00%

Monthly Percentage of Uninsured Visits for FQHC Centers

3 of 7

16.5% 16.8% 16.8% 16.6% 16.3% 15.9%15.2% 15.2%

9.8%

7.7%6.6%

5.6% 5.9% 5.5%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

FY17 Q1 Avg

FY17 Q2 Avg

FY17 Q3 Avg

FY17 Q4 Avg

FY18 Q1 Avg

FY18 Q2 Avg

FY18 Q3 Avg

FY18 Q4 Avg

FY19 Q1 Avg

FY19 Q2 Avg

FY19 Q3 Avg

FY19 Q4 Avg

FY20 Q1 Avg

FY20 Q2 Avg

Percentage of Uninsured Visits in ICS Dental

Actuals Target

16.1%

16.5%

14.9% 14.8% 14.8% 14.7%15.3%

14.9% 14.7% 15.0%13.8%

14.5%15.3%

0%

5%

10%

15%

20%

FY17 Q1 Avg

FY17 Q2 Avg

FY17 Q3 Avg

FY17 Q4 Avg

FY18 Q1 Avg

FY18 Q2 Avg

FY18 Q4 Avg

FY19 Q1 Avg

FY19 Q2 Avg

FY19 Q3 Avg

FY19 Q4 Avg

FY20 Q1 Avg

FY20 Q2 Avg

Percentage of Uninsured Visits in Primary Care

Actuals Target

Notes: Payer Mix for Primary Care Health Service Center shows the percentage of patient visits per payer and per Quarter

FQHC Monthly Percentage of Visits by Payer for ICS Primary Care Health Centers

4 of 7

59.9%

12.6%9.9%

15.3%

2.3%0%

10%

20%

30%

40%

50%

60%

70%

80%

(FY17_Q1) (FY17_Q2) (FY17 _Q3) (FY17_ Q4) (FY18_ Q1) (FY18_ Q2) (FY18_ Q3) (FY18_ Q4) (FY19_ Q1) (FY19_ Q2) (FY19_ Q3) (FY19_ Q4) (FY20_Q1) (FY20_Q2)

Payer Mix for ICS Primary Care Health Center

CareOregon DMAP/Medicaid/FamilyCare Medicare Self-Pay Commercial FamilyCare Ceases Operations

FQHC Primary Care Member Assignments

5 of 7

CareOregon FY20 average: 35,711Providence FY20 average: 3,805

Current Month Current Month % Previous Month Previous Month %

Monthly change in number of assigned

members Increase(Decrease)

CareOregon 35,720 90.37% 35,919 90.48% (199)Providence 3,807 9.63% 3,780 9.52% 27 Total Clients 39,527 100.00% 39,699 100.00% (172)

35,720

9,776

3,807

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

Jul-

16

Au

g-16

Sep

-16

Oct

-16

No

v-1

6

Dec

-16

Jan

-17

Feb

-17

Mar

-17

Ap

r-1

7

May

-17

Jun

-17

Jul-

17

Au

g-17

Sep

-17

Oct

-17

No

v-1

7

Dec

-17

Jan

-18

Feb

-18

Mar

-18

Ap

r-1

8

May

-18

Jun

-18

Jul-

18

Au

g-18

Sep

-18

Oct

-18

No

v-1

8

Dec

-18

Jan

-19

Feb

-19

Mar

-19

Ap

r-1

9

May

-19

Jun

-19

Jul-

19

Au

g-19

Sep

-19

Oct

-19

OHP Primary Care Member Assignments

Member Assignments CareOregon Member Assignments - Family Care Member Assignments - Providence

FQHC Gross Collection Rate by PayerMarch 2018 – October 2019

7 of 7

51%

45%

15%

59%

44%

60%

0%

10%

20%

30%

40%

50%

60%

70%

$0

$10,000,000

$20,000,000

$30,000,000

$40,000,000

$50,000,000

$60,000,000

$70,000,000

Medicaid Totals: Medicare Totals: Self-Pay Commercial CareOregon Medicaid Reproductive Health

Collection Rate by Payer (Visits dates Mar 2018 - Oct 2019)

Payments by Svc Date Charges by Svc Date Gross Collection Rate %

Medicaid Totals: Medicare Totals: Self-Pay Commercial CareOregon MedicaidReproductive

Health

Payments by Svc Date $8,093,210 $4,112,547 $1,796,405 $1,888,158 $25,718,977 $590,186

Charges by Svc Date $15,963,570 $9,058,013 $11,673,723 $3,212,189 $57,857,422 $981,472

Gross Collection Rate % 51% 45% 15% 59% 44% 60%

1/8/2020

Community Health Centers - Page 1

Grants – Incentives: External agreements that are determined by meeting certain metrics.

Grants – All Other: The County receives various Federal and State grants for specific programmatic purposes.

Health Center Fees: Revenue from services provided in the clinics that are payable by insurance companies.

Self Pay Client Fees: Revenue from services provided in the clinics that are payable by our clients.

Personnel: Costs of salaries and benefits.

Contracts: professional services that are provided by non‐County employees: e.g., lab and x-ray services, interpretation services, etc.

Materials and Services: non‐personnel expenses the program needs to perform its mission: e.g., medical and dental supplies, repairs & maintenance, supplies, etc.

Multnomah County Health DepartmentFederally Qualified Health Center Financial Statement

For Period Ending October 31, 2019

Revenue: are tax and non-tax generated resources that are used to pay for services.

Behavioral Health: Revenue earned by the Mental Health Division in its capacity as an insurance provider for Medicaid clients (by way of Health Share of Oregon).

General Fund: The general fund is the primary operating fund for the County, and is used to account for and report all financial resources not accounted for and reported in another fund. All County departments have some part of their operations either reported in or supported by the general fund.

Grants – BPHC: The Bureau of Primary Health Care grant revenue is isolated here. This grant is sometimes known as the Primary Care 330 (PC 330) grant.

Expenses: are what the County spends to provide services to the community. Expenditure categories include personnel, materials and supplies, internal services, contracted services, and capital.

Write-offs: Write-offs occur when the actual amount received for a claim differs from the amount originally recorded at the time of service. Transactions are recorded as revenue, but they can be positive or negative.

G:\FIN RPTS\FY20\04 October\FQHC\04 October FQHC Financial Statement

1/8/2020



Community Health Centers - Page 2

Internal ServicesFTE Count AllocationPC Inventory, Multco AlignFTE Count (Health HR, Health Business Ops)FTE Count (HR, Legal, Central Accounting)Telephone InventoryActive Mail Stops, Frequency, Volume

Records Items Archived and Items RetrievedMotor Pool Actual Usage

Capital Outlay: Capital Expenditures- purchase of capital items that cost $5,000 or more that have an expected useful life of more than one fiscal year: e.g., medical and dental equipment.

Department IndirectCentral IndirectTelecommunicationsMai/Distribution

Facilities/Building ManagementIT/Data Processing


1/8/2020



Community Health Centers - Page 3 October Target: 33% Adopted Budget

Revised Budget

Budget Change Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 July-Dec Total

% thru Dec

RevenueBehavioral Health 80,189$ 80,189$ -$ 5,957$ 6,634$ 6,683$ 6,697$ -$ -$ 25,970$ 32%General Fund 11,447,820$ 11,447,820$ -$ 961,109$ 957,959$ 961,279$ 993,411$ -$ -$ 3,873,759$ 34%Grants - BPHC 9,795,045$ 9,795,045$ -$ 570,116$ 1,654,676$ 1,052,012$ (3,198,754)$ -$ -$ 78,050$ 1%Grants - Incentives 8,179,053$ 8,179,053$ -$ 165,822$ 260,303$ 239,849$ 1,555,532$ -$ -$ 2,221,506$ 27%Grants - All Other 9,316,223$ 9,316,223$ -$ 260,242$ 685,613$ 657,556$ (185,966)$ -$ -$ 1,417,445$ 15%Health Center Fees 101,367,399$ 101,367,399$ -$ 2,701,914$ 15,061,267$ 5,833,564$ 8,953,472$ -$ -$ Self Pay Client Fees 1,025,053$ 1,025,053$ -$ 70,020$ 84,041$ 86,395$ 88,663$ -$ -$ Write-offs -$ -$ -$ -$ -$ -$ -$ -$ -$

Total 141,210,782$ 141,210,782$ -$ 4,735,180$ 18,710,495$ 8,837,338$ 8,213,055$ -$ -$

ExpensePersonnel 93,124,347$ 93,170,825$ 46,478$ 7,226,645$ 7,122,474$ 7,165,144$ 7,833,065$ -$ -$ Contracts 4,770,314$ 4,729,689$ (40,625)$ 205,587$ 221,687$ 485,107$ 632,042$ -$ -$ Materials and Services 16,623,150$ 16,612,630$ (10,520)$ 1,338,876$ 1,393,348$ 1,658,297$ 1,674,595$ -$ -$ Internal Services 26,083,970$ 26,088,637$ 4,667$ 797,366$ 1,491,180$ 3,414,947$ 1,943,355$ -$ -$ Capital Outlay 609,000$ 609,000$ -$ -$ -$ -$ -$ -$ -$

Total 141,210,782$ 141,210,782$ -$ 9,568,474$ 10,228,689$ 12,723,496$ 12,083,057$ -$ -$

Surplus/(Deficit) -$ -$ -$ (4,833,294)$ 8,481,805$ (3,886,158)$ (3,870,002)$ -$ -$


1/8/2020



Community Health Centers - Page 4 October Target: 33% Adopted Budget

Revised Budget

Budget Change Jan-20 Feb-20 Mar-20 Apr-20 May-20 Jun-20

Year to Date Total % YTD

RevenueBehavioral Health 80,189$ 80,189$ -$ -$ -$ -$ -$ -$ -$ 25,970$ 32%General Fund 11,447,820$ 11,447,820$ -$ -$ -$ -$ -$ -$ -$ 3,873,759$ 34%Grants - BPHC 9,795,045$ 9,795,045$ -$ -$ -$ -$ -$ -$ -$ 78,050$ 1%Grants - Incentives 8,179,053$ 8,179,053$ -$ -$ -$ -$ -$ -$ -$ 2,221,506$ 27%Grants - All Other 9,316,223$ 9,316,223$ -$ -$ -$ -$ -$ -$ -$ 1,417,445$ 15%Health Center Fees 101,367,399$ 101,367,399$ -$ -$ -$ -$ -$ -$ -$ 32,550,216$ 32%Self Pay Client Fees 1,025,053$ 1,025,053$ -$ -$ -$ -$ -$ -$ -$ 329,120$ 32%Write-offs -$ -$ -$ -$ -$ -$ -$ -$ -$ -$

Total 141,210,782$ 141,210,782$ -$ -$ -$ -$ -$ -$ -$ 40,496,067$ 29%

ExpensePersonnel 93,124,347$ 93,170,825$ 46,478$ -$ -$ -$ -$ -$ -$ 29,347,329$ 31%Contracts 4,770,314$ 4,729,689$ (40,625)$ -$ -$ -$ -$ -$ -$ 1,544,424$ 33%Materials and Services 16,623,150$ 16,612,630$ (10,520)$ -$ -$ -$ -$ -$ -$ 6,065,116$ 37%Internal Services 26,083,970$ 26,088,637$ 4,667$ -$ -$ -$ -$ -$ -$ 7,646,848$ 29%Capital Outlay 609,000$ 609,000$ -$ -$ -$ -$ -$ -$ -$ -$ 0%

Total 141,210,782$ 141,210,782$ -$ -$ -$ -$ -$ -$ -$ 44,603,716$ 32%

Surplus/(Deficit) -$ -$ -$ -$ -$ -$ -$ -$ -$ (4,107,649)$

Notes: Financial Statement is for Fiscal Year 2020 (July 2019 - June 2020). Columns are blank/zero until the month is closed.

After working with new accounting software for more than half a year, we reevaluated how to best use the grants module functionality. We are making changes over the course of several months that require a series of correcting entries. This is the reason for the negative grant revenue lines in October. We expect to complete this project in January.

Total year to date revenue for Grants - BPHC is understated by approximately $4.2 million in the report above as a result of the changes noted above.

Total year to date revenue for Grants - All Other is understated by approximately $580 thousand as a result of the changes noted above.

Total year to date revenue for Grants - All Other is understated by an additional $850 thousand due to a delay in renewal of a large contract with the State of Oregon. This will be corrected in November.


HEALTH DEPARTMENT EFFECTIVE DATE: Approval date unless otherwise specified

Policy #: FIS.01.06 Page 1 of 4

Title: Uncollectible Client Accounts and Payment Plans Policy #: FIS.01.06 Section: Fiscal and Ordering Chapter: Fiscal Procedures

Approval Date:

Approved by: Mark Lewis, Sr. Finance Manager

Approved by: Chair, Community Health Council

Related Procedure(s): Not applicable Related Standing Order(s): Not applicable

Applies to: Multnomah County’s Federally Qualified Health Center, including primary care, dental, student health centers, and pharmacy.

PURPOSE

This policy describes the specific circumstances in which the health center will waive uncollected fees or payments due to a client’s inability to pay.

DEFINITIONS

Term Definition

Client Balance Client balance refers to charges after all services have been billed to all third-party carriers, including Medicare, Medicaid (OHP including Healthshare/CareOregon/Providence, etc), private insurance companies, other health maintenance organizations (HMOs) and other special billing programs such as the Reproductive Health.

POLICY STATEMENT

It is the policy of the Multnomah County Health Center (MCHC) to provide needed health care services to its clients regardless of their ability to pay. MCHC informs clients of state and federal programs to assist them including the Sliding Fee Discount Program. In order for MCHC to remain fiscally solvent, MCHC will make every reasonable effort to bill for all covered services and supplies. It is MCHC’s policy to collect for services rendered, in accordance with the



benefits and reimbursement policies of all payer contracts. MCHC adheres to accepted accounting practices and therefore writes off client account balances that are deemed to be uncollectible.

Client Balances

Balances on client accounts can be either due from the client or a third-party payer. Third-party payers include Medicare, Medicaid (OHP including Healthshare/CareOregon/Providence, etc), private insurance companies, other health maintenance organizations (HMOs) and other special billing programs such as the Reproductive Health. When a client’s charges are not covered by third-party payers, the charges become the responsibility of the client. All third-party billings should be completed before transferring an account balance to client responsibility. Charges to the client are always discounted based on Multnomah County Health Center’s existing sliding fee discount rules. All sliding-fee adjustments should be provided to the client prior to writing off uncollectible amounts.

At no time should a credit balance of any amount be written off.

Write-offs should only be done by health center administration, medical billing staff or by automation approved by the Medical Billing Supervisor.

Uncollectible Accounts Criteria

Medical billing staff will conduct a daily write-off based on the documented write-off criteria. Accounts must meet all three of the criteria below.

● client self-pay balance is aged >365 days, aged by responsibility date for self-pay balance.

● client has not made a payment on the account in the past 365 days

Balances that meet the above criteria will be removed from accounts receivable but the health center will continue to track this debt on the account. Clients may still pay on these previous balances. Debt related to unpaid Medicare deductibles and coinsurance will be removed completely from accounts as part of the Medicare bad debt reimbursement process.

Deceased Clients

Upon verification of deceased status in the client chart, self-pay balances for deceased clients will be written off.

Staff recommendations for write-off

Staff may recommend client self-pay balances to be written off by assuring that the balances meet the write-off criteria or special circumstances and forwarding a request to their clinical



leadership, who will then forward to Medical Billing staff. Final approval will be made by the Medical Billing Supervisor. The following information must be provided by interoffice, email or phone to the medical billing staff:

● The client’s account number

● Date(s) of service to be written off

● The amount to be written off

● The approval from the clinic manager’s/ops supervisor

● The reason that the write-off is recommended

Collections and Bankruptcy

The MCHC will not pursue collections for clients, including those who present with a bankruptcy. MCHC will follow all applicable laws related to bankruptcy.

Payment Plans

clients with a self pay balance of $200 and over will be encouraged to set up a payment plan excluding the following account types:

● Confidential,

● Foster care,

● Community Dental,

● MVA,

● or Workers Compensation Accounts

All clients with a personal/family, family planning, and/or dental account are eligible for a payment plan.

The minimum monthly payment amount for a payment plan is $5.

Vaccines for Children(VFC)

The County will write off the costs associated with the vaccine administration code for any vaccine provided to a client participating in the Vaccines for Children (VFC) who is not able to pay.

REFERENCES AND STANDARDS

● HRSA’s Health Center Compliance Manual, Chapter 16: Billing and Collections

https://bphc.hrsa.gov/programrequirements/compliancemanual/chapter-16.html#titletop



● Vaccines for Children Program

PROCEDURES AND STANDING ORDERS

Not applicable

RELATED DOCUMENTS

Name

Not applicable

POLICY REVIEW INFORMATION

Point of Contact: Mark Lewis, Sr Finance Manager

Supersedes: Not Applicable

https://www.oregon.gov/oha/PH/PREVENTIONWELLNESS/VACCINESIMMUNIZATION/IMMUNIZATIONPROVIDERRESOURCES/VFC/Pages/index.aspx

HEALTH DEPARTMENT EFFECTIVE DATE: Approval date unless

otherwise specified

Policy #: Policy number Page 1 of 3

Title: Credit-Balance Policy

Policy #: Policy number

Section: Fiscal and Ordering Chapter: Enter chapter title

Approval

Date:

Enter policy approval date. Approved by:

Mark Lewis, Sr Finance Manager

Chair, Community Health Council

Related Procedure(s): Not applicable

Related Standing Order(s): Not applicable

Applies to: Multnomah County’s Federally Qualified Health Center, including primary care, dental, student health centers, and

pharmacy.

PURPOSE

This policy describes how the health center will handle accounts with a credit balance

DEFINITIONS

Term Definition

Credit Balance A credit balance results when the total of the credits posted to a

client's account (e.g., payments, etc.) exceeds the total of the charges applied or applicable to the account.

Credit balance eligible for a refund

A credit balance eligible for a refund is one where all the applicable charges and credits have been posted to the account and the refund

has been reviewed and adjusted based on the application of current eligibility criteria or any other applicable conditions.

POLICY STATEMENT

Maintaining client balances for protracted periods of time tends to create a barrier to care for clients without resources to pay. It is the Health Center’s policy to resolve credit balances on

client accounts as promptly as possible and in compliance with all applicable regulations by issuing eligible refunds to the client or third party.


otherwise specified


The Health Center adheres to generally accepted accounting practices and handles accounts with a credit balance in a timely and accurate manner.

Credit balances on accounts may occur for a number of reasons including but not limited to the following:

● Payment for provider, supplier or physician services after benefits have been exhausted, or where the individual was not entitled to benefits.

● Incorrect application of the deductible or coinsurance.

● Payment for non-covered items and services, including medically unnecessary services or custodial care furnished an individual.

● Payment based on a charge that exceeds the reasonable charge.

● Duplicate processing of charges/claims.

● Payment to a billable provider on a non-assigned claim or to a beneficiary on an assigned claim. (Payment made to wrong payee.)

● Primary payment for items or services for which another entity is the primary payer

● Payment for items or services rendered during a period of non-entitlement.

● Payments or adjustments posted incorrectly

Upon verification, the overpayments process will be initiated within 60 days of being identified.

The accounts receivable team will make a diligent effort to refund credit balances directly to

the client or third-party. In cases in which the client or third-party are unreachable, accounts receivable will follow the required submission process for remitting unclaimed property to the Department of State Lands.

The Accounts Receivable month end process will include the review of the Credit Balance Report and properly addressing credit balances.

REFERENCES AND STANDARDS

● HRSA’s Health Center Compliance Manual, Chapter 16: Billing and Collections

● Oregon’s Department of State Lands, Division Rules, Chapter 141, Division 45, Administration of Unclaimed Property

https://bphc.hrsa.gov/programrequirements/compliancemanual/chapter-16.html#titletop

https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=334

https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=334


otherwise specified


PROCEDURES AND STANDING ORDERS

Not applicable

RELATED DOCUMENTS

Name

Not applicable

POLICY REVIEW INFORMATION

Point of Contact: Mark Lewis, Sr Finance Manager

Supersedes: Not applicable

2020 Board Calendar Community Health Council

619 NW 6th Avenue, Portland, OR 97209 (503) 988-9492

January: 01/13 CHC Public Meeting 6-8 pm 01/27 Executive Committee Meeting 5:45-7:15 pm February: 02/10 CHC Public Meeting 6-8 pm 02/24 Executive Committee Meeting 5:45-7:15 pm March: 03/09 CHC Public Meeting 6-8 pm 03/23 Executive Committee Meeting 5:45-7:15 pm April: 04/13 CHC Public Meeting 6-8 pm 04/27 Executive Committee Meeting 5:45-7:15 pm May: 05/11 CHC Public Meeting 6-8 pm 05/26* Executive Committee Meeting 5:45-7:15 pm June: 06/08 CHC Public Meeting 6-8 pm 06/22 Executive Committee Meeting 5:45-7:15 pm July: 07/13 CHC Public Meeting 6-8 pm 07/27 Executive Committee Meeting 5:45-7:15 pm August: 08/10 CHC Public Meeting 6-8 pm 08/24 Executive Committee Meeting 5:45-7:15 pm September: 09/14 CHC Public Meeting 6-8 pm 09/28 Executive Committee Meeting 5:45-7:15 pm

426 SW Stark, Portland, Oregon 97204. Phone: 503.988.9492

October: 10/12 CHC Public Meeting 6-8 pm 10/26 Executive Committee Meeting 5:45-7:15 pm November: 11/09 CHC Public Meeting 6-8 pm 11/23 Executive Committee Meeting 5:45-7:15 pm December: 12/14 CHC Public Meeting 6-8 pm 12/28 Executive Committee Meeting 5:45-7:15 pm *Date adjusted for Holiday

community health council meeting minutes - monday, january

Documents